• Physical Therapy Korea
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• v.30 no.1
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• pp.1-7
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• 2023

Background: Like many other countries, falls and related injuries in older adults are great concerns in South Korea. In particular, falls are common in medical institutions, often causing the increase of the length of hospitalization. Objects: The purpose of this review was to help understand and address falls in hospitalized individuals in South Korea. Methods: The review was conducted on literature published in Korean from 2010 to 2022, searched in the Korea Citation Index and PubMed. Keywords used for the search were as follows: falls, fall risk, fall risk assessment, hospital, inpatient, intervention, Korea, and prevention. Results: A total of 54 articles were found and reviewed. The most common place of fall accidents was the inpatient room, where there were many cases of falls while walking. Loss of balance was the most common cause of falls, and many falls occurred in patients admitted to the internal medicine. Furthermore, a risk of falling increased with the type of medications taken. In terms of tools to assess patients' fall risk, the Morse Fall Scale (MFS) was commonly used. Patient-specific fall prevention activities were common to address falls, and they decreased the frequency of falls and the fear of falling. Factors influencing the effectiveness of the fall prevention activities included attitudes toward falls, education, environmental factors, patient safety culture, and self-efficacy in preventing falls. Conclusion: Our results should help understand and address falls and injuries in medical institutions.

• PNF and Movement
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• v.21 no.3
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• pp.387-401
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• 2023

Purpose: The purpose of this study was to develop a Korean version of the Falls Efficacy Scale (K-FES), which is used to measure the fear of falling, that is conceptually equivalent to the original and culturally adaptable to the Korean population. Methods: A five-step translation and adaptation process was employed to create the K-FES, adhering to the established guidelines for cross-cultural rehabilitation outcome measures. The content validity was then evaluated by 22 rehabilitation professionals (15 males and 7 females) with an average clinical experience of 201 months at neurological rehabilitation centers. The content validity ratio and index were used as a basis for judgment. Results: The translation process identified inconsistencies with the terms "objects" and "telephone" in the original Falls Efficacy Scale, which were subsequently resolved in the final K-FES version. The content validity ratios for the original, second, and third versions of the K-FES ranged from -0.27-0.91, -0.27-0.91, and -0.27-0.91, respectively. Correspondingly, the content validity index values for the original, second, and third versions of the K-FES ranged from 0.77-1.00, 0.68-1.00, and 0.63-1.00, respectively. Conclusions: The K-FES was rigorously developed through translation, adaptation, and validation processes, making it a reliable tool for Korean stroke rehabilitation professionals. It is expected to be instrumental in clinical and research settings to assess postural stability and fall risk in patients with strokes and brain injuries.

• 한국노년학
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• v.37 no.1
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• pp.237-250
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• 2017

The purpose of this study is to analyze the effects of exercise program for prevention of falling on physical fitness, posture and fall prevention self-efficacy for elderly women. 30 females above the age of 65 were subjects for this study. Over an twelve week period, 14women in the experimental group performed exercise 2 times a week for 60 minutes per session. 16women in the control group didn't participate in the exercise program. The independent variable was a exercise program for prevention of falling. Dependent variables were physical fitness, posture and fall prevention self-efficacy. Prevention of falling exercise program is consisted of an elastic band using exercise and Korean dance movement exercise. Physical fitness consisted of grip strength, upper and lower body endurance, cardiovascular endurance, flexibility, balance, coordination. The posture was measured the static posture when standing, using a high-resolution camera, body style to automatically measure the distance and angle(M-zen, Korea). Posture was measured in both the coronal and sagittal plane via reference board. Fall prevention self-efficacy was measured via questionnaire using the Korea Falls Self-Efficacy Scale (FES-K). The physical fitness, posture and fall prevention self-efficacy were measured twice with pre and post exercise, and the difference between groups with Wilcox signed rank test, and the group-specific post verification was carried out with U-validated methods (Mann Whitney U test). Statistical significance level was verified by setting the p<.05. Lower body endurance, cardiovascular endurance, flexibility, balance and coordination significantly increased in the experimental group. The control group was no significant increase in physical fitness variables. shoulder slope angle, pelvic slope angle(coronal/sagittal), leg length difference, scapular inferior angle and left/right calcaneus angle significantly decreased in the experimental group. Both the experimental group and control group were no significant increase in fall prevention self efficacy. The prevention of falling exercise program for elderly women indicated the positive changes in physical fitness(except grip strength) and posture(except upper body slope). However, there are no significant differences of falling prevention self-efficacy between the both group. Thus, the prevention of falling exercise program for the elderly has been proved that it is highly efficient on improving physical fitness and posture proofreading. However, we still need to consider supplement exercise for grip strength and upper body slope.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.4
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• pp.61-71
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• 2017

PURPOSE: The purpose of the present study was to investigate the effects of whole body vibration exercise on balance, muscle strength and falls efficacy in the elderly. METHODS: In this blinded randomized allocation study, 27 elderly were assigned to a whole-body vibration exercise group (n=14), consisting of 25 min structured exercises for 2 days per week for 6 weeks and a control group (n=13) performing the same program without vibration. At baseline and after the 6-week intervention, balance was measured using the Korean version of the Berg balance scale (K-BBS), timed up and go (TUG) test and functional reach test (FRT). Muscle strength was determined using the 30-s chair stand test (CST). Fear of falling was assessed using the Korean version of falls efficacy scale (K-FES). Paired t-test and independent t-test were used for within and between group comparisons, respectively. RESULTS: After the intervention, the experimental group showed significantly higher changes in all the parameters (K-BBS score, TUG test, CST, K-FES score) (p<.05) compared with the control group. However, there was no significant change in all parameters in the control group (p>.05). CONCLUSION: The whole-body vibration exercise program may be helpful to improve balance, mobility, muscle performance and fear of falling in the elderly.

• PNF and Movement
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• v.18 no.2
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• pp.233-244
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• 2020

Purpose: The study investigated pain and falls as psychological factors in Total Knee Replacement patients and examined the relationship between these factors. Methods: Ninety-six total knee replacement patients aged 69.31±7.01 (male: 21, female: 75) participated in the study. Post-surgery pain was assessed on a visual analog scale, and fall risk scores were evaluated on fall fear and fall efficacy scales. Other psychological factors assessed included national anxiety and trail anxiety, fear prevention, Beck depression score, and psychological health measures. The data were analyzed using SPSS version 22.0. Results: A statistically significant correlation was found between pain before surgery and FES fall fear score before surgery (p < 0.05). A statistically significant correlation was found between pain after surgery and PWBS fall fear score after surgery (p < 0.05). A statistically significant correlation was found between state anxiety and PWBS, Trail anxiety (p < 0.05). A statistically significant correlation was also found between trail anxiety and BDI, PWBS (p < 0.05). State anxiety and fear avoidance before surgery were found to affect trail anxiety, and pain before surgery and fall fear score before surgery were found to affect FES. In addition, PWBS was found to affect BDI. Conclusion: The study confirms that increased pain in Total Knee Replacement patients can be a risk factor for falls. In addition, fall fears increase fear avoidance and cause psychological deterioration. This suggests that efforts should be made to reduce pain and to manage psychological factors.

• The Journal of Korean Physical Therapy
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• v.34 no.2
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• pp.57-62
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• 2022

Purpose: The purpose of this study was to determine the effects of bilateral visual feedback training with visual targets on the postural balance and fall efficacy of stroke patients with hemiparesis. Methods: A total of 24 stroke patients with hemiparesis were randomly assigned to either a bilateral visual feedback training (BVFT, n=8) group, unilateral visual feedback training (UVFT, n=8) group, or a control group (n=8). The BVFT and UVFT groups performed weight-bearing training on the bilateral (less-affected and affected side) or unilateral side (affected side) with visual feedback using visual targets. The control group performed squat training without visual feedback using visual targets. The training program was conducted in the form of 3 sets a day, 3 times a week, for 4 weeks. The participants were evaluated using the Berg balance scale (BBS), lateral reaching test (LRT), timed up and go test (TUG), and the activities-specific balance confidence scale (ABC). Results: In the intra-group comparison after the intervention, the BVFT group showed a significant difference in the BBS, TUG, affected and less-affected side LRT, and ABC (p<0.05). The UVFT group showed a significant difference in the BBS and ABC (p<0.05). In the inter-group comparison after the intervention, the BVFT group showed significant improvements in their BBS, affected side LRT, and TUG, when compared to the control group (p<0.05). Conclusion: These findings show that bilateral visual feedback training with visual targets during bilateral weight-bearing exercises can improve the postural balance function in stroke patients.

• Journal of muscle and joint health
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• v.16 no.1
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• pp.5-12
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• 2009

Purpose: The purpose of this study was to investigate bone mineral density(BMD) and fear of falling and falls efficacy in the middle and old aged women over 50 years. Methods: The subjects consisted of 409 women. One-way ANOVA, Pearson's correlations and multiple regression were used to test the BMD, fear of falling and falls efficacy scale by using SPSSWIN 12.0. The BMD of the calcaneus were measured with peripheral dual energy x-ray absorptiometry(DEXA). Results: The average age was 63 years old and the average T-score was -3.21 in patient with osteoporosis, -1.72 with osteopenia, and .13 with normal. There were significant differences in the status of the BMD according to age(p=.000), height(p=.000), weight(p=.000), married status(p=.000), age of menarche(p=.002), and menopause(p=.002). The fear of falling was related with falls efficacy(r=-.247, p=.01), BMD(r=-.337, p=.01). Falls efficacy($\beta$=-.21, p=.000)and BMD($\beta$=-.26, p=.000) were predicting variables of fear of falling. The model explained 13% of the variance in fear of falling(F=27.38, p=.000). Conclusion: Fear of falling and falls efficacy were related with the bone mineral density. Falls efficacy and BMD may be useful for the predicting fear of falling for women in middle and old age. Further studies with assessment of fall-related risk-factors and a longitudinal study are necessary to assess with falls efficacy, and BMD with age.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.471-478
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• 2021

Background: The effect of lumbar spinal stenosis (LSS) and peripheral vascular disease (PVD), which occurs with similar degenerative conditions, when seen together, has not been studied. The aim of this study is to examine and compare the relationship between pain, balance, disability, fear of falling, and kinesiophobia in LSS patients with intermittent vascular claudication (IVC). Methods: Seventy-two patients diagnosed with LSS using magnetic resonance imaging participated in this study. Thirty-five patients with IVC symptoms and showing vascular lesions by lower extremity venous and arterial Doppler ultrasonography imaging were included in the IVC-LSS group. The pain, static balance, dynamic balance, disability, fear of falling, and kinesiophobia were evaluated using the numeric rating scale, single leg stance test, Time Up and Go (TUG), the Oswestry Disability Index (ODI), Fall Efficacy Scale-International (FES-I), and Tampa Scale for Kinesiophobia (TSK), respectively. Results: Age and female sex were found to be higher in the IVC-LSS group (P = 0.024; P = 0.012). The IVC-LSS group had a shorter single leg stance time and TUG test duration, pain intensity, ODI, FES-I, and TSK scores were higher than patients with LSS (P = 0.001). Pain, fear of falling, and kinesiophobia were moderately correlated with disability in the IVC-LSS group. No relationship was found between pain and dynamic balance. Also, the pain was not related to kinesiophobia. Conclusions: The findings indicated that IVC causes loss of balance and an increase in pain, disability, fear of falling, and kinesophobia in patients with LSS.

• Journal of agricultural medicine and community health
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• v.38 no.4
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• pp.243-256
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• 2013

Objectives: This study was to investigate fear of falling and related factors in elderly living alone based on fall experience. Methods: Participants were 404 elderly women(faller=148, non-faller=256) over 65 years who were homebound living alone in Jeollanam-do Province. Face-to-face interviews were conducted using questionnaires from April $23^{th}$ to June $9^{th}$ 2013. The questionnaires consisted of demographic variables, fall experience, Fear of falling questionnaire(FOFQ), Falls Efficacy Scale(FES) and Center for Epidemiologic Studies Depression(CES-D). The collected data were analyzed using the SPSS version 14.0. Results: The fear of falling and the influential factors were different according to fall experience. Regression model for fear of falling in fallers significantly accounted for 46.1%(F=6.71, p<0.001); difficulty of performing activity, depression, fall-efficacy, static balance and assistive devices. Regression model for fear of falling in non-fallers significantly accounted for 55.2%(F=15.16, p<0.001); fall-efficacy, environmental hazards, difficulty of performing activity, risk of nutrition, housing type, dizziness and assistive devices. Conclusion: Results demonstrate that fall is an important health problem for elderly women living alone, and show fall experience for factors influencing fear of falling. These results could be used in the developing fall prevention programs.

• The Journal of Internal Korean Medicine
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• v.43 no.5
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• pp.1018-1028
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• 2022

Objectives: Parkinson's disease is characterized by progressive, irreversible damage to dopamine neurons in the substantia nigra pars compacta, as well as motor and non-motor symptoms. This disease currently has no dependable disease-modifying treatment. In this paper, we describe the treatment of a 67-year-old female with Parkinson's disease using acupuncture and exercise therapy. Case Presentation: Clinical symptoms and the United Kingdom Parkinson's Disease Society Brain Bank Diagnostic Criteria were used to diagnose the patient with Parkinson's disease. Over a 12-week period, the patient visited a Korean medicine hospital 18 times and was treated with acupuncture and exercise therapy in addition to anti-Parkinson's drugs. Before and after treatment, clinical examinations were performed using tools such as the Unified Parkinson's Disease Rating Scale, Fall Efficacy Scale, Parkinson's Disease Questionnaire, Berg Balance Scale, and Non-Motor Symptoms Scale. Furthermore, functional near-infrared spectroscopy was used to assess cortical hemodynamics. All clinical examination results improved after 12 weeks of intervention. In particular, improvements on the Total Unified Parkinson's Disease Rating Scale and Part III of this scale demonstrated large, clinically important differences. Conclusion: This case suggests that combining acupuncture and exercise therapy could produce an effective treatment for Parkinson's disease patients.